OBJECTIVES: To compare efficacy of rosuvastatin (RSV) and ezetimibe/simvastatin (E/S) to take dyslipidemic patients to their LDL-C goals according to ATPIII guidelines in the cardiology clinical practice. Secondary objective was to compare the efficacy of both treatments to change lipids levels (LDL-C, TC, TG, HDL-C ApoB/ApoA1 index) from baseline to week 8. METHODS: Files from dyslipidemic outpatients in the Cardiology Unit of a 3rd level hospital in Mexico City were reviewed between Jan 2004 - Dec 2005. Patients treated with either RSV 10mg/day or E/S 10/20mg/day and lipid determinations before (basal) and after 8 weeks of treatment were included. Regression models were used to adjust outcome measures for age, sex, CHD, baseline LDL-C, and therapy duration. To assess the primary objective, patients were classified as achieving lipid goals or not according to ATPIII. Statistic analysis was made with a proportion test. For secondary objectives, mean percent lipid change (MPLC) achieved by each treatment were noted and differences detected by Student's t test with a p<0.05 for significance. RESULTS: Files from 98 (age 63.1±12.4 years) patients treated with RSV and 89 (age 65.8±12.8 years) treated with E/S were reviewed. There were no significant differences between groups at baseline. A total of 81.4% and 46.4% RSV patients achieved the 2001 and 2004 lipid ATPIII goals respectively, versus 58.4% and 31.5% E/S patients (p<0.01). The MPLC were: LDL-C: RSV -46.7±13.6 versus E/S -35±21.3 (p<0.001); TC: RSV -33.6±12.7 versus E/S -25.8±16.7 (p<0.001); HDL-C: RSV 9.9±16.9 versus E/S 4.17±16.5 (p=0.012) ApoB/ApoA1 index: RSV -21±29 versus E/S -10.7±20 (p=0.019). There were no reports of adverse events with any treatment. CONCLUSION: More RSV patients achieved their LDL-C goals than E/S patients. RSV treatment reduced more LDL-C, TC and apoB/apoA1 index (atherogenic lipid profile) and higher HDL-C levels than E/S in the usual clinical practice in Mexican patients.